腹腔镜直肠癌根治术中保留左结肠动脉可行性的研究

doi:10.3969/j.issn.1006-6233.2018.02.029

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Abstract Objective: To explore the feasibility of preserving Left colic artery (LCA) in laparoscopic radical resection of rectal cancer. Methods: The clinical data of 102 cases of laparoscopic rectal radical resection admitted in our hospital from July 2014 to January 2017 were retrospectively analyzed, including 36 cases with preservation of LCA (the experimental group)and 66 cases without preservation of LCA(the control group). Through comparing the operative time, blood loss, postoperative exhaust time, pull out time of pelvic drainage tube, the number of lymph nodes removed around the root of inferior mesenteric artery, to get the difference in the surgical outcome between the two groups. Results: No significant difference was found in intraoperative blood loss [65 (20-300) vs 70 (10-400) ml, p=0.848], operative time [165 (104-270) vs 183 (100-328) min,p=0.368], pull out time of pelvic drainage tube[12.5 (6-44) vs 13 (7-120),p=0.220], postoperative exhaust time [6 (2-12) vs 6 (2-18), p=0.253], the number of lymph nodes removed around the root of IMA [15.694±2.745 vs 16.288±3.262,p=0.356]between the two groups. 2 cases of anastomotic leakage occurred in the preservation group,while 14 cases of anastomotic leakage occurred in the none-preservation group (p=0.038), there was statistical difference between the two groups (P<0.05), it can be proved that the experimental group can effectively reduce the occurrence of anastomotic leakage. Conclusion: The operation of preserving the left colonic artery in laparoscopic radical resection of rectal cancer reduce the incidence of anastomotic leakage and don't increase the risk of operation. It is a safe and feasible operation.

Key words： Rectal carcinoma Left colic artery Inferior mesenteric artery Anastomotic leakage Low-tie ligation

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2018.02.029 OR http://www.hbyxzzs.cn/EN/Y2018/V24/I2/286

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